scholarly journals Global initiative gold and national recommendations on the management of patients with chronic obstructive pulmonary disease (COPD): the place of double bronchodilation

2019 ◽  
pp. 17-21
Author(s):  
A. A. Vizel ◽  
I. Yu. Vizel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Evidence Base ◽  
Chronic Obstructive ◽  
National Guidelines ◽  
Obstructive Pulmonary Disease ◽  
Global Initiative ◽  
Long Acting ◽  
Real Practice

Chronic obstructive pulmonary disease (COPD) is a chronic, environmentally mediated disease manifested by broncho-obstructive syndrome, which is not completely reversible.The purpose of this review was to summarize the latest changes in the management of these patients, which occurred in international and domestic guidelines.Methods. The analysis of work on the problem of COPD, available in the E-Library and PubMed electronic libraries, was carried out.Results. The year 2019 was marked by the renewal of global GOLD initiatives and the implementation of national guidelines for the diagnosis and treatment of COPD in practice. The most significant provisions are the following: double long-acting bronchodilators are the main treatment for stable COPD; specific indications are needed for the administration of ICS and they are not universal in the treatment of COPD; not all double bronchodilators are the same – their evidence base is not yet equivalent. The analysis of real practice shows that the use of shortacting bronchodilators, ICS and triple therapy remains excessive.Conclusion. Understanding of COPD is improving, identifying the most vulnerable points, problems, the solution of which will make it possible to take new steps to improve the quality of life of these patients and reduce mortality. 

scholarly journals Chronic obstructive pulmonary disease in ambulatory practice

2008 ◽  
pp. 29-33
Author(s):  
N. M. Shmeleva ◽  
V. P. Sidorova ◽  
A. S. Belevsky ◽  
E. I. Shmelev
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Outpatient Clinic ◽  
Chronic Obstructive ◽  
National Guidelines ◽  
Obstructive Pulmonary Disease ◽  
Incorrect Diagnosis ◽  
Educational Programmes ◽  
Inadequate Therapy

Quality of outpatient management of patients with chronic obstructive pulmonary disease (COPD) and ways to improve it have been studied in this trial. The study included analysis of 560 medical recorders of outpatients followed up in one and the same outpatient clinic by one and the same physician for 5 to 10 yrs and who were currently newly diagnosed for COPD, epidemiological investigation using questionnaire and spirometry in all patients attending the outpatient clinic, and organization of educational COPD center for physicians, nurses and patients. We assessed concordance of the patients' management according to medical records to national guidelines. Most frequent discrepancies were inaccurate recording of the patient's symptoms and history, incomplete and inadequate examination, incorrect diagnosis, inadequate therapy. Functional disorders were not estimated in 95.9 % of the patients, COPD stage was not determined in 100 % of the cases, severity was not assessed in 83.9 %, and 70.7 % of the patients were not diagnosed for complications and exacerbations of the disease. Inhaled bronchodilators were not administered in 41.9 % of the patients, 90 % of the patients were inadequately treated with antibiotics, 100 % of the patients were not vaccinated. The main reasons for this mismatching were thought to be poor awareness of COPD by physicians, lack of pneumologists in outpatient clinics, and insufficient technical provision of the outpatients clinics with spirographs, oxymeters, etc. The epidemiological examination involved 8 672 patients, among them 38 % reported respiratory symptoms and 24 % had ventilatory disorders. COPD was firstly diagnosed in 768 patients. Implementation of educational programmes have led to necessary functional investigations to be used twice more frequent.

Diagnosis and management of COPD in primary care

2021 ◽  
Vol 14 (4) ◽  
pp. 350-355
Author(s):  
Katarzyna Mycroft ◽  
Katarzyna Górska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Treatment Initiation ◽  
Disease Diagnosis ◽  
Chronic Obstructive ◽  
Disease Treatment ◽  
Obstructive Pulmonary Disease ◽  
Long Acting ◽  
Significant Health

Chronic obstructive pulmonary disease is a significant health problem. However, a large proportion of cases remain undiagnosed. Early diagnosis of chronic obstructive pulmonary disease leads to earlier treatment initiation, and in consequence, to improvement of patients quality of life. The gold standard for chronic obstructive pulmonary disease diagnosis is spirometry and the presence of irreversible obstruction after a bronchodilator. One of the most important interventions in the treatment of chronic obstructive pulmonary disease is anti-smoking education. The main group of drugs used in chronic obstructive pulmonary disease treatment are the long-acting bronchodilators.

Inhaled therapy for chronic obstructive pulmonary disease

2021 ◽  
Vol 32 (Sup10) ◽  
pp. S15-S22
Author(s):  
Andrew Booth
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inhaled Steroids ◽  
Flu Vaccination ◽  
Inhaled Therapy ◽  
Long Acting ◽  
Careful Assessment

Chronic obstructive pulmonary disease is characterised by progressive symptoms of productive cough, breathlessness, wheeze and exacerbations. Airway obstruction is detected by quality assured spirometry, and is defined as a Forced Expired Volume in one second / Forced Vital Capacity ratio <0.7. Inhaled therapy is the most effective treatment solution, with bronchodilators and inhaled steroids helping to improve symptoms, quality of life and lung function, while reducing risk of exacerbations. Bronchodilators are available as both monotherapy and as dual combination therapy. Inhaled steroids can be added to inhaled long-acting bronchodilators, but are not without significant complications, including pneumonia. Therefore, careful assessment of the phenotype of a patient with chronic obstructive pulmonary disease must be given before commencing any therapy that contains inhaled steroid and other treatments, such as flu vaccination, smoking cessation and pulmonary rehabilitation should be given due consideration.

Early bronchodilatory response to the first dose of indacaterol/glycopyrronium as an additional individual predictor of their effectiveness in the treatment of chronic obstructive pulmonary disease

2020 ◽  
Vol 22 (4) ◽  
pp. 17-22
Author(s):  
N. V. Sharova ◽  
S. L. Grishaev ◽  
D. V. Cherkashin ◽  
S. V. Efimov ◽  
M. A. Kharitonov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Clinical Signs ◽  
Chronic Obstructive ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease ◽  
Long Acting ◽  
The Impact

The effectiveness of the early bronchodilatory response of the first dose of a fixed double combination of long-acting bronchodilators of various classes indacaterol/glycopyrronium and long-acting anticholinergics glycopyrronium and Tiotropium in patients suffering from stable chronic obstructive pulmonary disease is compared. It was found that in all patients included in the study and suffering from chronic obstructive pulmonary disease, changes in functional respiratory indicators were accompanied by positive and comparable dynamics of clinical signs: a decrease in the severity of shortness of breath, the impact of the disease on the quality of life and increased tolerance to physical activity. It was found that the combination of indacaterol/glycopyrronium provides rapid, pronounced and prolonged bronchodilation in patients suffering from chronic obstructive pulmonary disease compared to the separate use of glycopyrronium and Tiotropium. Consistent use of glycopyrronium and salbutamol leads to maximum bronchodilation, which makes it advisable to separate the use of prolonged bronchodilators when initiating therapy for chronic obstructive pulmonary disease. Therefore, there is a clinical feasibility of taking not only fixed combinations of bronchodilators of different classes, but also their consistent use. The results of an early bronchodilatory response to the first dose of indacaterol/glycopyrronium can be used as an additional individual predictor of their effectiveness in the treatment of chronic obstructive pulmonary disease.

Inhaled therapy for chronic obstructive pulmonary disease

2020 ◽  
Vol 2 (9) ◽  
pp. 486-494
Author(s):  
Andrew Booth
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inhaled Steroids ◽  
Flu Vaccination ◽  
Inhaled Therapy ◽  
Long Acting ◽  
Careful Assessment

Chronic obstructive pulmonary disease is characterised by progressive symptoms of productive cough, breathlessness, wheeze and exacerbations. Airway obstruction is detected by quality assured spirometry, and is defined as a Forced Expired Volume in one second / Forced Vital Capacity ratio <0.7. Inhaled therapy is the most effective treatment solution, with bronchodilators and inhaled steroids helping to improve symptoms, quality of life and lung function, while reducing risk of exacerbations. Bronchodilators are available as both monotherapy and as dual combination therapy. Inhaled steroids can be added to inhaled long-acting bronchodilators, but are not without significant complications, including pneumonia. Therefore, careful assessment of the phenotype of a patient with chronic obstructive pulmonary disease must be given before commencing any therapy that contains inhaled steroid and other treatments, such as flu vaccination, smoking cessation and pulmonary rehabilitation should be given due consideration.

Tiotropium: A Bronchodilator for Chronic Obstructive Pulmonary Disease

2005 ◽  
Vol 39 (9) ◽  
pp. 1467-1475 ◽  
Author(s):  
Heather Somand ◽  
Tami L Remington
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Data Extraction ◽  
Tiotropium Bromide ◽  
Chronic Obstructive ◽  
Anticholinergic Agent ◽  
Obstructive Pulmonary Disease ◽  
Study Selection ◽  
Long Acting

OBJECTIVE: To review the scientific literature evaluating the efficacy and tolerability of tiotropium bromide, a new bronchodilator indicated for treatment of chronic obstructive pulmonary disease (COPD). DATA SOURCES: Articles were identified through searches of MEDLINE (1966–January 2005) using the key words tiotropium, BA 679 BR, chronic obstructive pulmonary disease, and anticholinergic agents. Additional citations were identified from bibliographies of publications cited. STUDY SELECTION AND DATA EXTRACTION: Experimental and observational studies of tiotropium bromide were selected. Trials of the efficacy of the drug in humans were the focus of the review. DATA SYNTHESIS: Tiotropium bromide is an effective bronchodilator for patients with COPD. It produces clinically important improvements in lung function, symptoms of dyspnea, quality of life, and exacerbation rates compared with placebo. In comparative studies, tiotropium does not appear to be more efficacious than salmeterol or ipratropium. CONCLUSIONS: Tiotropium is an effective inhaled anticholinergic agent that is recommended among preferred long-acting bronchodilators for the chronic management of moderate to very severe COPD. Although similar to ipratropium in efficacy and tolerability, it has the advantage of once-daily dosing.

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